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RVMC ready to grow Mail Tribune / Roy Musitelli Rogue Valley Medical Center emergency room physician Victoria Harris examines Jean Latham Friday for injuries she may have suffered in a fall. RVMC's busy emergency room will be rebuilt as part of a $76 million expansion. Construction of the hospital's $76 million expansion could start this year; officials say the plan should meet its needs for 40 to 50 years By BILL KETTLER Mail Tribune Bonds go on sale Tuesday for the largest expansion project in Rogue Valley Medical Center's 44-year history. Hospital managers say their $76 million building plan will provide better emergency services, more private hospital rooms, improved surgery suites and better medical service for the region's growing population and its expanding senior community. Your hospital's old; now what? Many find themselves in situations similar to RVMC's People who follow the health-care industry say deciding when and how to rebuild, remodel or expand a hospital is one of the toughest decisions to make. Morss says many midsized regional hospitals sooner or later find themselves in the situation that prompted Rogue Valley Medical Center to rebuild. "You start out with a community hospital and everything's great," he says. "Then you add on and add on, and pretty soon you've got this 'pudding' building. There's a little chocolate pudding over here, and a little vanilla pudding over there, and nothing quite works." Morss says designing efficient hospital spaces is far too complex for most hospitals to do on their own. Asante hired Colorado-based Health Futures Development Group to work with its architect, Mahlum Architecture of Portland, to design the project. "Technology is a big driver," Ballantyne says. "There are 35 uses for an endoscope now, where there used to be one." Hospitals reach a point where remodeling or adding to existing space compromises efficiency. Trying to upgrade old wiring and plumbing while keeping a hospital running is "like trying to change your spark plugs while your motor's running," says Ballantyne, who formerly managed Bay Area Hospital in Coos Bay. In any community with more than one hospital, managers also have to consider how their decisions affect their share of the market. "There are always two bottom lines," Ballantyne says. "Can (a hospital) make money and stay financially stable? Can it provide good care?" Rogue Valley Medical Center served 63.7 percent (14,735) of the 23,136 patients who were admitted to Jackson County's three hospitals in 2000. Providence Medford Medical Center served 29.6 percent (6,849) and Ashland Community Hospital served 6.7 percent (1,552), according to statistics in Oregon Business magazine. "It's a symptom of the broader problem," Seccombe says, "where health care is viewed as a competitive business instead of a social service. There's a movement toward thinking of hospital patients as customers." Seccombe says for-profit hospitals have prospered in many areas of the United States by aggressively marketing "the newest and best" in medical care. Nonprofit hospitals sometimes develop similar marketing strategies to maintain their share of the patient market. "That's one of the reasons our spending on health care is rising so dramatically," she says. "We all want more, and new. Somehow bigger and newer gets equated with better." "It's not just a five-year plan," says Roy Vinyard, president of Asante Health System, the parent organization for Rogue Valley Medical Center. "This truly will meet our needs for 40 to 50 years at least." Construction could begin this year, and some projects could be completed by late 2005, says Scott Kelly, Asante's vice president for planning, marketing and business development. Asante also operates the 98-bed Three Rivers Community Hospital in Grants Pass. Kelly says U.S. Census data suggests population in Asante's nine-county service area will grow by 32 percent by 2020, from 530,000 to 700,000. Census figures also indicate that the over-65 component in Jackson and Josephine counties (RVMC's primary service area) will more than double, from about 44,000 in 2000 to about 102,000 in 2020. "The baby boomers are a-coming," Kelly says, "and we have to be prepared for what's coming." He says the region's increasingly older population will create more demands on the health-care system than a similar number of younger (and generally more healthy) people. "When you're over 65, you use more (medical) services and you're in the hospital longer." Funding for the project will come from tax-free bonds issued through the city of Medford's Hospital Facilities Authority. As a nonprofit corporation, Asante can use the city's bonding capability, but interest and principal payments are solely Asante's responsibility. The Medford City Council approved Asante's request to issue up to $90 million in bonds. "It's a lot of money," Vinyard says, "but it's spread over a long period of time." Kelly declined to discuss details of financing the project, but he notes that interest rates right now are low. That means Asante likely will be able to sell the bonds at an interest rate in the 4 percent range. Sources in the financial community say Asante probably will pay about $7 million to $8 million per year in principal and interest if it issues $90 million in bonds over a 30-year term. Hospital managers have christened the project "the RVMC rebuild," but the look of the medical center will change dramatically. A new four-story "bed tower" with 160 new single-occupancy rooms will rise over the site of the present emergency services. A large, spacious lobby and reception area will give the hospital's entrance the open, friendly feel of a shopping mall. "Admitting will be easier," Kelly says, "and way-finding will be easier." The new lobby effectively will make the hospital's present entrance on Barnett Road a "back door," but traffic still will enter the campus from Barnett. Other entrances will be located off Black Oak Drive, Siskiyou Boulevard and Murphy Road. Construction plans also call for a new emergency department just west of the new patient rooms and new surgery suites on the east side, as well as a new cafeteria and food service area. Kelly says the project acknowledges the growing role of technology in treating disease. A new diagnostic imaging unit will provide more space for the growing array of increasingly sophisticated tools that physicians use to look inside the body. There also will be four new suites for endoscopic procedures such as colonoscopy. Other components of the plan will give the hospital more capacity to handle growing patient volume. A new emergency services department will more than triple the capacity of the original emergency room. The e-room was designed to handle 15,000 visits per year, but volume has grown recently to 32,000 visits. The new department will have capacity for 48,000 visits, with room to expand for a total of 60,000 visits. The project also includes 20 new pre- and post-operative beds for short-stay surgery patients and four new surgery suites. Kelly says hospital administrators will decide how to equip those surgery suites when they are completed, based on the demands for surgery. Some features of the plan address inefficiencies that have developed since the hospital opened in 1958. Five expansion projects have allowed the hospital to keep pace with growth and add new medical equipment, but the add-ons inevitably require staff to spend more time walking from place to place. The existing bed units, for example, were built as long, narrow corridors, which increases the distance nurses have to walk. The imaging department (X-rays, CT scans) is currently spread across two floors."We can react to the demand," Kelly says, "but we can't do it efficiently." Other aspects of the project reflect changing attitudes about health care. All but two of the new patient rooms, for example, will be single-occupancy because patients, physicians and staff agree that private rooms are better. Shared rooms, for example, lack the privacy that families have come to expect when they want to discuss medical matters around a patient's bedside. "Families are much more involved in care today," Kelly says. He notes that family members often want to stay with a patient overnight, and the new rooms will include couch space that can be used as a bed. "Our goal is to have 85 percent private beds," Kelly says. While the project adds 160 private rooms to the hospital, the net gain will be just 56 beds, from today's 228 to 284. The hospital will close 106 existing rooms. The former patient rooms will be used for support functions such as accounting. Kelly says the project probably will not require the hospital to raise its rates because the costs will be amortized over 30 years and hundreds of thousands of patients. He says it's difficult to pinpoint exactly how much the expansion would cost each patient because so many factors influence the cost of medical care. "I wouldn't want to say RVMC will never have to raise our rates," he says, "but we haven't sat down and said, 'We're going to raise our rates x percent on account of this project.' " Thousands helped RVMC get going Thousands of Southern Oregon residents donated money to start the enterprise that has become Rogue Valley Medical Center. Need drove the project forward. Medford's Rogue Valley Memorial Hospital had lost its accreditation, and Sacred Heart Hospital had announced it planned to close. Orchardist A.S.V. Carpenter pledged $500,000 if people in the community would match his donation, and dozens of volunteers buttonholed friends, neighbors and strangers to pitch in. Medford had barely 25,000 residents when the new 80-room Rogue Valley Memorial Hospital opened on May 1, 1958. The hospital was the most expensive building in town, with a price tag of $2.8 million. The hospital began to grow soon after it was opened. In 1962, an additional 80 beds were added, and in 1963, the hospital opened the region's first intensive care unit. A pediatric unit opened the same year. The hospital's first radiation equipment to treat cancer arrived in 1967. In the 1970s, the hospital offered several new kinds of care to residents of Southern Oregon and Northern California. A neonatal intensive care unit opened in 1972, and a cardiovascular laboratory came the following year. By 1976, nurses were administering chemotherapy for cancer patients, and in 1977, the hospital performed its first open-heart surgery. More patient beds were added in 1973, increasing the total to 264. The hospital changed its name to Rogue Valley Medical Center in 1982, reflecting its growing prominence as a regional treatment center. During the 1980s, the hospital continued to expand its services, drawing more patients from surrounding counties in southwestern Oregon and far northern California. The Smullin Health Education Center opened in 1988. During the 1990s, RVMC added more space for surgery and for treating critically ill patients. In 1994, the Dubs Cancer Center was opened and more radiation therapy equipment was installed. In 1999, the cancer center expanded to provide extra room for infusion therapy, oncologists' offices and a clinical research center. Today the hospital employs more than 1,900 people and serves about 15,000 inpatients and more than 400,000 outpatients per year. Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.